Provider Demographics
NPI:1952089997
Name:NEWTON, QUATISHA LAS (LPC-IT)
Entity Type:Individual
Prefix:MRS
First Name:QUATISHA
Middle Name:LAS
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:QUATISHA
Other - Middle Name:LAS
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8900 S WOOD CREEK DR APT 108
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-7535
Mailing Address - Country:US
Mailing Address - Phone:773-817-6929
Mailing Address - Fax:
Practice Address - Street 1:2600 N MAYFAIR RD STE 100
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1303
Practice Address - Country:US
Practice Address - Phone:414-939-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7423-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional